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As fentanyl deaths rise, state legislatures resist 'harm reduction' method


But first, we turn to the fentanyl epidemic. Yesterday Pennsylvania state Senate passed a bill that would ban supervised drug injection clinics. These are programs that aim to reduce overdose rates. But as fentanyl deaths keep surging, some state lawmakers nationwide are pushing back against so-called harm reduction programs. NPR addiction correspondent Brian Mann is with us to talk about this backlash. Hi, Brian.


PFEIFFER: Would you first define harm reduction?

MANN: Yeah. So it takes most people experiencing addiction, especially severe addiction with a drug like fentanyl, a long time to recover. So the goal of harm reduction is to keep people alive and as healthy as possible until they can get treatment and counseling. The Biden administration has really been emphasizing this approach as deaths have soared, making medical care and addiction treatment medications more widely available. And some organizations want to go even further than the Biden team. They're pushing for programs like supervised drug injection sites, places where people can use street drugs under medical supervision and get help if they overdose.

PFEIFFER: And these are very controversial programs. So as we've said, some state legislatures are pushing back. Where is this happening?

MANN: Well, we're seeing bipartisan discomfort with these ideas all over the U.S. In Philadelphia, where more than 1,200 people a year are dying from overdoses, there's a group called Safe House. They've been negotiating with the U.S. Justice Department, hoping to open one of these clinics. But Democratic state lawmaker Christine Tartaglione, who represents a part of Philadelphia hit hard by drug addiction, introduced a bill that would ban this kind of clinic. Here she is speaking with WHYY.

CHRSTINE TARTAGLIONE: My constituents do not want safe injection sites in the neighborhood. I think it enables addiction. We should be in the business of getting these folks treatment.

MANN: Now, decades of research contradict that argument that these clinics enable drug use. But the ban passed the state Senate this week in Pennsylvania by a wide margin with bipartisan support - still has to make its way through the State House. I should say state lawmakers in Colorado also recently voted down a measure that would have allowed similar supervised injection sites.

PFEIFFER: Beyond pushback to these sites, are state lawmakers trying to limit other types of harm reduction?

MANN: Yeah. Yeah. They really are. West Virginia has made it much harder for communities to open needle exchange programs that are proven to help reduce the spread of diseases like HIV/AIDS. In Idaho, lawmakers recently passed a measure to limit federal funding for Narcan or naloxone. This is a drug proven to reverse opioid overdoses. I spoke about this trend with Ronda Goldfein. She's on the board of Safe House. That's the group that wants to open the supervised drug use clinic in Philadelphia. She says it's frustrating that lawmakers are backing away from public health strategies that might save lives.

RONDA GOLDFEIN: We're in an overdose crisis. The safe way to proceed is to really look at all of the options and not just rule things out because it doesn't seem right.

MANN: And one other part of this trend, Sacha, is state legislatures, Nevada being the latest, that are pushing much tougher criminal penalties, including mandatory prison time, for people caught with even really small amounts of fentanyl.

PFEIFFER: And, Brian, why are states moving in this more conservative direction?

MANN: Well, there are so many deaths, 80,000 fentanyl deaths now a year, more people struggling with addiction. It's become a political flashpoint. I spoke about this with Kendra Neumann. She's a drug policy analyst at a nonpartisan group called the Colorado Health Institute. She says there's really a contest underway over how to approach this addiction crisis.

KENDRA NEUMANN: You know, people have felt since the pandemic that there have been increasing crime rates. Homelessness in Colorado in particular has become more visible. And a lot of people associate that with drug use. And I think that has just heightened the conversation about overdoses and about drug use.

MANN: Experts I talked to, Sacha, say pressure on state lawmakers to keep getting tougher on fentanyl - it's only going to grow as we head into next year's election season.

PFEIFFER: NPR's Brian Mann. Thank you.

MANN: Thank you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.